The purpose of the first interview section of MDS 3.0 is to assess the
resident's cognitive patterns. The Brief Interview for Mental Status efficiently
provides insight into the resident's current condition and helps to identify
needed supports. Most residents are able to attempt this brief interview for
mental status. Without an attempt at structured cognitive interview a resident
may be mislabeled based on his or her appearance or assumed diagnosis. Now we
will demonstrate an interview. Score the interview as you watch. To do this you
need to know that it is Monday, November the 23rd, 2009. Before watching and
scoring the interview, review the coding instructions in the manual.
"Mrs. Jones. Mrs. Jones. Mrs. Jones I'd like to ask you those questions now. We
ask these questions of everyone, and we do it so we can better plan your care.
Some of the questions may seem easy, others more difficult. Are you ready?"
(Mrs. Jones nods) "Ok, I'm going to say 3 words for you to remember. Please
repeat the words after I have said all 3. The words are sock, blue, and bed. Now
tell me the 3 words."
"Bed, blue, blue's my favorite color."
Interviewer: "Ok, yes, two of the words are bed a piece of furniture and blue a
color. The third, sock, is something that you wear. Now tell me the 3 words."
"The blue socks are on the bed."
"Ok, now can you tell me what year it is right now?"
"Don't you know?"
"We ask these questions so that we can better plan your care. Please tell me the
year we're in."
"Um, 1999 the millennium."
"And what month is it?"
"November, my grandchildren made that turkey for me."
"Oh, very creative. And, what day of the week is it?"
"Monday. Monday we play bingo. It's Monday."
"You play bingo on Monday?"
"Monday."
"Wonderful. Now let's get back to the earlier question. What were those 3 words
I asked you to repeat?"
"Blue."
"Ok, and something that you wear?"
"Dress."
"Ok, and a piece of furniture?"
"Bed."
"Ok. Now, I'd like to ask you some questions about your mood. Would that be
alright with you?"
The resident's responses provide a total score of 8, indicating possible
moderate cognitive impairment. You notice that the assessor did not total the
score while talking to the resident. The score was based on the following: C200
is 2, C300A is 0, C300B is 2, C300C is 1, C400A is 0, C400B is 2 and C400C is 1.
Although you do not know the reason for the cognitive impairment, your observation of
behavior and responses to these specific items will also help you better code
the delirium questions C1300A to D. You also learned that she could use
environmental cues and verbal reminders to improve her interactions and recall.
Do not be concerned that she used these environmental cues to answer some
questions. Those questions should still be coded as correct.